Improving the refinement, scientific and intelligent level of hospital operation and management is an inevitable requirement for the high-quality development of public hospitals. At the Imedway Summit 2023, Wei Ying, Chief Accountant of the Fourth Hospital of Hebei Medical University, shared the hospital's experience in the construction of HRP operation and management.
The Fourth Hospital of Hebei Medical University (Hebei Provincial Cancer Hospital), founded in 1955, has developed into a comprehensive large-scale tertiary hospital integrating medical treatment, teaching, scientific research, prevention and health care, and featuring the highest quality tumors. At present, the hospital has 2,741 open beds, an annual outpatient volume of 1.74 million, and an annual surgical volume of 290,000, 10 admissions80,000 people.
In the 2018-2021 national performance appraisal of 1,335 general hospitals across the country, the Fourth Hospital of Hebei Medical University won A+ for four consecutive years, ranked 47th in the country in 2021, and ranked 4th in the country in CMI value.
1.The necessity of establishing a sound operation management system in hospitals
In 2020, the National Health Commission issued the "Guiding Opinions on Strengthening the Operation and Management of Public Hospitals", which introduced the basic concepts, overall requirements and basic principles of the operation and management of public hospitals, clarified the key tasks of operation and management, and pointed out that it is necessary to strengthen information support and improve the quality of decision-making.
In the face of development difficulties such as high operating costs and lack of effective implementation of cost control, hospitals are also actively seeking solutions to balance resource allocation, accelerate the implementation of performance reforms, and achieve high-quality and sustainable development.
Under this background, after many arguments, investigations and comparisons, the Fourth Hospital of Hebei Medical University chose Donghua Medical University as the hospital for constructionThe hospital's integrated operation management system (HRP) has reduced operating costs, improved operational efficiency, and improved medical quality.
2.The effectiveness of the construction of the operation management system
The integration of industry and finance promotes the maximization of the overall value of the hospital
Business finance is deeply integrated into all aspects of the hospital value chain, providing full-process business financial management and maximizing the overall value of the hospital.
The financial system is connected with his, material management and other systems, and the automatic management of vouchers and drug materials in and out of the warehouse is realized. The system also realizes the direct connection between bank and doctor and intelligent reconciliation, which greatly improves the work efficiency of financial personnel, liberates personnel productivity, and transforms the value of financial functions from traditional transaction processing to management control and decision support, promotes the value appreciation of the hospital, and provides strong support for the operation of the hospital.
Multi-level and multi-dimensional comprehensive cost accounting to support the refined management of hospitals
Through the information platform of HRP integrated operation management, multiple systems such as HIS, human resources, finance, cost, project, and disease types are opened up, and accounting and analysis are carried out from multiple levels and dimensions to escort the high-quality development of the hospital.
Cost accounting starts from the refinement of data, starting from the five levels of project, disease, diagnosis and treatment group, department and hospital, carries out cost accounting in a hierarchical manner, classifies and records all the consumption conditions formed at each level, collects and analyzes, and improves the construction of the hospital cost accounting system with the support of the information system. Form two lines of revenue and expenditure, formulate refined units, complete data collection, and allocate according to scientifically set apportionment methods and multi-dimensional apportionment parameters, so as to improve the authenticity and usefulness of cost report data. Finally, accounting reports and classification reports are generated, which are displayed in graphical form, providing strong support for the continuous improvement of the hospital's refined cost management.
Build a comprehensive budget system to effectively control the budget process
Through the establishment of the budget internal control system, the budget management and other business systems are fully connected, and the budget process is effectively controlled. With the budget number as the source of data circulation, it runs through all aspects of budget preparation, approval, implementation control, budget analysis, and assessment. Real-time control of budget generation, and can provide multi-dimensional analysis and statistics.
Establish a budget management committee and related organizational structures, and the centralized department will collect the information of the departments under its jurisdiction, and adopt a "more up and more down" method for declaration and approval. In the implementation process, each department can see how much should be implemented and the current implementation status from the computer, which has a good guiding role for the department, and forms a report every monthly, quarterly, semi-annually and annually, and feeds back to the department, so that the department can adjust and improve itself in this process.
Establish a multi-performance plan to further scientifically distribute performance
Construct a multi-performance scheme based on four dimensions: RBRVS point value, standardized workload, other special assessments, and cost assessments.
The establishment of a multi-performance appraisal system has completely changed the performance distribution model based on the balance of income and expenditure, and effectively put an end to the phenomenon that the bonus of medical staff is linked to income. Through the RBRVS point value, the difficulty and work value of medical service projects are scientifically reflected, and medical staff are encouraged to study medical technology more actively and improve the level of diagnosis and treatmentWith medical service income and key cost control as the core, pay attention to the ratio of department income to power, guide departments to further optimize the income structure, increase medical service income, and reduce operating costsAccording to different categories of departments, special performance appraisal and distribution methods are set up to fully reflect the characteristics of disciplines and hospital management objectives. After the implementation of the new performance distribution plan, the positive incentive effect of performance distribution has appeared, the hospital's operating indicators have continued to improve, and the medical income structure has been further optimized.
The performance appraisal system is interconnected with his and other systems, realizing the automatic extraction of basic data such as income, cost, and workload, and realizing the automatic accounting of bonuses of various departments in accordance with the comprehensive performance appraisal and distribution plan of the hospital, which greatly reduces the workload of the staff of the accounting department, and significantly improves the work efficiency and data accuracy.
Through the development of the above work, the Fourth Hospital of Hebei Medical University has also made innovative inventionsAdministrative MDT workAn MDT team composed of 10 departments, including the Quality Control Office, the Medical Department, the Outpatient Department, and the Nursing Department, has been formed. The medical department and the quality control office communicate the completion of indicators to the departments that need key feedback every month, and put forward suggestions for improvement. The clinical department holds a monthly quality control meeting to find out the deficiencies according to the completion of the quality control indicators, analyze the causes, and formulate practical improvement measures.
With the in-depth promotion of the hospital's HRP construction, the hospital's performance indicators such as the average length of stay, the proportion of minimally invasive surgery, and the proportion of drug consumption have been greatly improved. In the 2018-2021 national performance appraisal of 1,335 general hospitals across the country, the Fourth Hospital of Hebei Medical University won A+ for four consecutive years, ranked 47th in the country in 2021, and ranked 4th in the country in CMI value.
Reform is always on the way. In the next stage, the hospital will start with risk management and audit management, do more work in strengthening the construction of the internal control system, and further promote the high-quality development of the hospital through the construction of the operation management system, so as to realize the digital transformation of hospital operation and management.
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